Trends in lipid profiles and control of LDL-C among adults with diabetes in the United States: An analysis of NHANES 2007-2018

BACKGROUND AND AIM

To determine trends in lipid profiles and lipid control in US adults with diabetes and assess variation in these trends across sex and race/ethnicity from 2007 to 2018.

METHODS AND RESULTS

Serial cross-sectional analysis of data from diabetic adults participating in the National Health and Nutrition Examination Survey (NHANES; 2007-2008 to 2017-2018). Among the 6116 participants included (weighted mean age, 61.0 years; 50.7% men), age-adjusted TC (p for trend < 0.001), LDL-C (p for trend < 0.001), TG (p for trend = 0.006), TG/HDL-C (p for trend = 0.014) and VLDL-C (p for trend = 0.015) decreased significantly. Age-adjusted LDL-C levels were consistently higher in women than in men over the study period. Age-adjusted LDL-C improved significantly for diabetic whites and blacks but did not change significantly for the other races/ethnicity. Lipid parameters improved for non-coronary heart disease (CHD) diabetic adults, except for HDL-C, while no lipid parameter significantly changed for diabetic adults with concomitant CHD. Among diabetic adults receiving statin therapy, age-adjusted lipid control remained unchanged from 2007 to 2018, as did adults with concomitant CHD. However, age-adjusted lipid control improved significantly for men (p for trend < 0.01) and diabetic Mexican Americans (p for trend < 0.01). In 2015-2018, female diabetic participants receiving statins had lower odds of achieving lipid control (OR: 0.55; 95% CI: 0.35-0.84; P = 0.006) than men. Differences in lipid control across different races/ethnicities no longer existed.

CONCLUSIONS

Lipid profiles improved in the US adults with diabetes from 2007 to 2018. Although rates of lipid control did not improve nationally in adults receiving statins, these patterns varied by sex and race/ethnicity.

A simple heat-based alternative method for deparaffinization of histological sections significantly improves acid-fast staining results for Mycobacteria in tissue

Histopathology is the study of how disease alters human and animal tissue and is based on the microscopic examination of stained tissue sections. To maintain tissue integrity, preserving it from degradation, it is initially fixed, primarily with formalin, before being treated with alcohol and organic solvents, allowing the infiltration of paraffin wax. The tissue can then be embedded in a mold and sectioned, usually at a thickness between 3 and 5 μm, before staining with dyes or antibodies to demonstrate specific components. As the paraffin wax is insoluble in water, it is necessary to remove it from the tissue section before applying any aqueous or water-based dye solution, to allow the tissue to successfully interact with the stain. This deparaffinization/hydration step is normally carried out using xylene, an organic solvent, followed by hydration using graded alcohols. However, this use of xylene has been shown to have detrimental effects on acid-fast stains (AFS), such as those employed to demonstrate Mycobacterium, including the causative agent of tuberculosis (TB), as the integrity of the lipid-rich wall present in these bacteria may be compromised using xylene. A simple, novel method, Projected Hot Air Deparaffinization (PHAD) removes the solid paraffin from the tissue section without the use of any solvents, which produces significantly improved staining results using AFS. PHAD relies on the projection of hot air onto the histological section to melt and remove paraffin from the tissue, which can be achieved using a common hairdryer. •PHAD relies on the projection of hot air onto the histological section which can be achieved using a common hairdryer.•The blowing force is such that melted paraffin is removed from the tissue in 20 min.•Subsequent hydration allows for using aqueous histological stains with success, such as the fluorescent auramine O acid-fast-stain.

Attenuated total reflection-Fourier transform infrared spectroscopy: a universal analytical technique with promising applications in forensic analyses

Contemporary criminal investigations are based on the statements made by the victim and the eyewitnesses. They also rely on the physical evidences found in the crime scene. These evidences, and more particularly biological ones, have a great judicial value in the courtroom. They are usually used to revoke the suspect’s allegations and confirm or refute the statements made by the victim and the witnesses. Stains of body fluids are biological evidences highly sought by forensic investigators. In many criminal cases, the success of the investigation relies on the correct identification and classification of these stains. Therefore, the adoption of reliable and accurate forensic analytical methods seems to be of vital importance to attain this objective. Attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR) is a modern and universal analytical technique capable of fingerprint recognition of the analyte using minimal amount of the test sample. The current systematic review aims to through light on the fundamentals of this technique and to illustrate its wide range of applications in forensic investigations. ATR-FTIR is a nondestructive technique which has demonstrated an exceptional efficiency in detecting, identifying and discriminating between stains of various types of body fluids usually encountered in crime scenes. The ATR-FTIR spectral data generated from bloodstains can be used to deduce a wealth of information related to the donor species, age, gender, and race. These data can also be exploited to discriminate between stains of different types of bloods including menstrual and peripheral bloods. In addition, ATR-FTIR has a great utility in the postmortem investigations. More particularly, in estimating the postmortem interval and diagnosing death caused by extreme weather conditions. It is also useful in diagnosing some ambiguous death causes such as fatal anaphylactic shock and diabetic ketoacidosis.

Use of different stains for microscopic evaluation for the diagnosis of Pythium keratitis

PURPOSE

To evaluate the efficacy of various staining techniques for detection of Pythium in keratitis cases.

METHODS

Data of nineteen consecutive culture-positive cases of Pythium keratitis were retrospectively analysed. Corneal scrapings and corneal buttons (in the cases which underwent therapeutic penetrating keratoplasty [TPK]) were sent for microbiological and histopathological examination. The direct smears were stained with Potassium hydroxide and calcofluor white (KOH ​+ ​CFW), Gram and Iodine-Potassium Iodide-Sulphuric Acid (IKI-H₂SO₄) stains. The corneal buttons were stained with Gomori's Methanamine Silver (GMS), Periodic Acid-Schiff (PAS) and Iodine-Potassium Iodide-Sulphuric Acid (IKI-H₂SO₄) stains. The positivity of various stains in detecting Pythium was studied.

RESULTS

Gram and KOH ​+ ​CFW staining from smear was done in 16 out of 19 (84.2%) cases. KOH ​+ ​CFW and Gram stains were suggestive of Pythium in 10 (62.5%) and 7 (43.8%) cases, respectively. IKI-H₂SO₄ staining in scraping samples was positive for Pythium in all the 4 (100%) cases in which it was performed. Half corneal buttons were positive for Pythium with IKI-H₂SO₄ stain as well as GMS stain in all the 18 cases that underwent TPK (100%). PAS stain showed weak to faint pink staining of Pythium filaments in 7 out of 18 cases (38.9%).

CONCLUSION

IKI-H₂SO₄ stain followed by KOH ​+ ​CFW stain detects Pythium filaments most accurately in corneal scraping samples from keratitis patients, although the differences were not statistically significant. The positivity of the stains depends on astute observation by an experienced ocular microbiologist and pathologist.

First Report of Epicoccum nigrum Causing Leaf Spot of Eugenia involucrata in Brazil

Eugenia involucrata (DC) is a native fruit species of forest formations in the Atlantic Complex and in the forests and savannas of the Paraná State, Brazil (Donadio, 2002). In February 2021, in the experimental area at the Universidade Tecnológica Federal do Paraná, in the Dois Vizinhos city, Paraná State, Brazil, a foliar disease was observed on twenty-two12 years old E. involucrata trees, with 20 to 80% of the leaves per tree affected. Symptoms were small, irregularly to circular shaped, reddish-brown lesions with yellow halos. As the disease progressed, the lesions increased in size and showed no distinction between mature and young tissues. Twenty symptomatic leaves (from each tree) from 11 trees grown at different locations in the orchard (50% of the total number of trees) were collected. For fungal isolation, the leaf surfaces were disinfected with 0.5% NaOCl solution for 1 min, rinsed in sterile distilled water (SDW) and dried on sterile filter paper. Five fragments (0.3 cm) of diseased leaf tissue were placed on potato dextrose agar medium. After 7 days of incubation at 25°C, orange colonies appeared, with a reddish pigment on the reverse side. Conidial were brown globular to pear solitary, verrucous and multicellular (average of 21.74 µm x 24.45 µm, n = 30). The morphological characteristics of the colony and conidia of the eight isolates matched the description of the fungal genus Epicoccum (Valenzuela-Lopez et al. 2018). Further identification of eight isolates was confirmed by amplifying and sequencing three phylogenic loci (ITS, β- tubulin and RPB2) using the ITS1/ITS4, Bt2a/Bt2b and 5F2/7cR primer pairs, respectively (White et al., 1991, Glass and Donaldson, 1995, O Donnell et al., 1998). The sequences of one representative isolate (ENcm) were submitted to GenBank (ITS, MZ442338, β-tubulin, MZ447127 and RPP2, MZ447128) respectively. A phylogenetic tree was constructed by the maximum likelihood method with 1,000 replicas of bootstrapping based on concatenated ITS, β-tubulin, and RPB2 sequences of the ENcm and strains of 14 species of the genus Epicoccum. Isolate ENcm grouped with Epicoccum nigrum stains CBS 173.73 (Chen et al., 2017). For the pathogenicity tests four young healthy branches containing 20 leaves were spray inoculated, with 1.5 mL of conidia suspension of ENcm (106 conidia/mL) covered with a punched transparent plastic bag and moistened with distilled water in orchard. The air temperature ranged from 14ºC to 25ºC. SDW was used as control. Three replicates (pathogen and control) on different trees were performed. After 7 days the fungus was re-isolated from the symptomatic lesion, showing morphological characteristics similar to those of ENcm. Control branches did not show fungal growth. The inoculation test was repeated once, confirming the symptoms described above. This is the first report of the leaf spot caused by E. nigrum on E. involucrata in Brazil as well as in the world. E. nigrum on E. involucrata leaves could pose potential threat on productivity, whose impact may affect the fruit tree's ability to perpetuate, its survival in natural conditions or in commercial orchards.

Differential expression of programmed cell death ligand 1 (PD-L1) and inflammatory cells in basal cell carcinoma subtypes

Few studies have evaluated programmed cell death ligand (PD-L1) expression and lymphocytic infiltrates in Basal Cell Carcinoma (BCC). The objectives of this study are to assess PD-L1 expression and markers of local immune response in nodular, superficial, and morpheaform BCC, and compare it to normal, sun-exposed skin from the periphery of intradermal nevi. This was a retrospective study that included three histological subtypes of BCCs, and sun-exposed skin from the periphery of dermal nevi as quality controls. Tissue microarrays (TMA) were constructed with subsequent staining of H&E and immunohistochemistry (IHC) for CD4, CD8, FOXP3 and PD-L1. Non-automated quantification of the infiltrate in the intratumoral and stromal compartments on TMAs was performed. A total of 115 BCC (39 nodular, 39 morpheaform, and 37 superficial) and 41 sun-exposed skin samples were included (mean age 65.4 years; 52.6% females). BCC showed higher expression of PD-L1 (5.4 vs 0.7%, p < 0.001), CD8 (29.8 vs 19.7%, p = 0.002), and FOXP3 (0.3 vs 0.06%, p = 0.022) compared to sun-exposed skin. There was a higher PD-L1 expression in nodular BCC compared with other subtypes. Low-risk BCC subtypes (superficial and nodular) exhibited more PD-L1 expression in intratumoral and stromal immune infiltrates as compared to high-risk BCC subtypes. As a limitation, no immune cells function was evaluated in this study, only the presence/absence of T-lymphocyte sub-populations was recorded. Substantial differences in both PD-L1 expression and lymphocytic infiltrates were found amongst the histological subtypes of BCC and sun-exposed skin. Highest PD-L1 expression was found in nodular BCCs which suggests a potentially targetable strategy in the treatment of this most common BCC subtype.

Influence of toothbrush abrasion and surface treatments on the color and translucency of resin infiltrated hybrid ceramics

PURPOSE

The study compared the color change, lightness, and translucency of hybrid resin ceramics exposed to toothbrush abrasion and surface treatment.

MATERIALS AND METHODS

Four hybrid ceramics [Lava Ultimate (LU), Vita Enamic (EN), Shofu HC (SH), and Crystal Ultra (CU)] were compared with a glass-ceramic (Vita Mark II) control. One hundred and twenty specimen blocks were prepared using a precision saw machine. Specimens in each material were divided into four subgroups based on the surface treatment (polishing or staining) and a storage medium (water or citric acid). Simulated tooth brushing with a mixture of 100 RDA (radioactive abrasives) with 0.3 ml distilled water was used for 3650 cycles (7300 strokes) for each specimen. Measurements for the color change, lightness, and translucency were measured after toothbrushing using a spectrophotometer. Statistical analysis compared outcomes using paired t-test, ANOVA, and Tukey post hoc test.

RESULTS

The maximum color change was identified in SH (stained acid) [1.44 (0.40)], whereas the lowest was identified in EN (polished water) [0.66 (0.16)] material. The maximum and minimum loss of surface translucency was observed in SH (polished water) [12.3 (0.52)] and EN (stained acid) [6.5 (0.55)] specimens, respectively. Lastly, loss of lightness was the highest in VM (polished acid) [69 (0.95)], whereas the lowest was observed in CU (stained water) [56.7 (0.86)].

CONCLUSION

The comparison presented a significant effect of toothbrush abrasion on translucency and lightness of the hybrid resin ceramics. Color change was not significantly influenced irrespective of the storage medium employed. Surface staining demonstrated the preservation and stability of color and optical properties under the influence of toothbrush abrasion and chemical trauma.

The Utility and Scope of Forensic Histopathology

Forensic histopathology is the use of histology to aid in the identification of disease and injuries in forensic pathology practice. The value of routine microscopy has been challenged in various studies and discussions have taken place in forensic journals about how useful microscopic diagnosis is in medicolegal autopsies. This paper reviews the literature on the value of histological examination in forensic practice and discusses routine histochemical stains that can be used in postmortem examinations to aid in the diagnosis and add value by confirming or refuting macroscopic findings.

Evaluation of Tumor-associated Tissue Eosinophilia in Different Stages of Oral Squamous Cell Carcinoma using Special Stains: An in vitro Histopathological Study

AIM

To evaluate the tissue eosinophilia in different stages and grades of oral squamous cell carcinoma (OSCC) and correlate its possible role as a prognosticator in primary OSCC using special stains like Congo red and carbol chromotrope.

MATERIALS AND METHODS

Forty-five intraoral histopathologi-cally proven cases of OSCC were selected (15 cases each of well-differentiated squamous cell carcinoma (WDSCC), moderately differentiated squamous cell carcinoma (MDSCC), and poorly differentiated squamous cell carcinoma (PDSCC)). Three sections of 4 pm were taken for each case. All slides were stained using routine stain, i.e., hematoxylin and eosin (H&E), and special stains, i.e., carbol chromotrope and Congo red respectively, for studying tissue eosinophils in all these groups. Histopathological evaluation was performed on paraffin sections for calculating the quantitative eosinophil distribution by two separate observers who were blinded to clinical and histopathological data. Tumor-associated tissue eosinophilia (TATE) was calculated using the density method.

RESULTS

An increase in the degree of TATE from stage I to stage IV suggested that elevated tissue eosinophilia was seen with an increasing size of primary tumor. Also an increase in TATE was observed with an increasing grade of OSCC. Chromotrope stain was found to be a much better and more specific stain for eosinophils, and gave more accurate eosinophil count compared with H&E and Congo red.

CONCLUSION

The findings of the present study highlight the significance of eosinophil counting and that it can be used as an additional morphological parameter in the grading of OSCC which can also be included in the biopsy report.

Coconut Oil Extract Mitigates Testicular Injury Following Adjuvant Treatment with Antiretroviral Drugs

Increased access to highly active antiretroviral therapy (HAART) has made the management of drug toxicities an increasingly crucial component of HIV. This study investigated the effects of adjuvant use of coconut oil and HAART on testicular morphology and seminal parameters in Sprague- Dawley rats. Twelve adult male Sprague-Dawley rats, weighing 153~169 g were distributed into four groups (A–D) and treated as follows: A served as control (distilled water); B (HAART cocktail- Zidovudine, Lamivudine and Nevirapine); C (HAART + Virgin coconut oil 10 mL/kg) and D (Virgin coconut oil 10 mL/kg). After 56 days of treatment, animals were killed and laparotomy to exercise the epididymis for seminal fluid analyses done whilst testicular tissues were processed for histomorphometric studies. Result showed a significant decline in sperm motility (P < 0.05) and count (P < 0.0001) in HAART-treated animals while there was insignificant changes in other parameters in groups C and D except count that was reduced (P < 0.0001) when compared with controls. Histomorphological studies showed HAART caused disorders in seminiferous tubular architecture with significant (P < 0.01) decline in epithelial height closely mirrored by extensive reticulin framework and positive PAS cells. Adjuvant Virgin coconut oil + HAART resulted in significant decrease in seminiferous tubular diameter (P < 0.05), but other morphometric and histological parameters were similar to control or Virgin coconut oil alone (which showed normal histoarchitecture levels). While derangements in testicular and seminal fluid parameters occurred following HAART, adjuvant treatment with Virgin coconut oil restored the distortions emanating thereof.

Hepatic histomorphological and biochemical changes following highly active antiretroviral therapy in an experimental animal model: Does Hypoxis hemerocallidea exacerbate hepatic injury?

As the roll-out of antiretroviral therapy continues to drive downwards morbidity and mortality in people living with HIV/AIDS (PLWHAs), organ toxicities (especially the liver) are frequently becoming a major concern for researchers, scientists and healthcare planners.

This study was conducted to investigate the possible protective effect of Hypoxis hemerocallidea (AP) against highly active antiretroviral therapy (HAART)-induced hepatotoxicity. A total of 63 pathogen-free adult male Sprague-Dawley rats were divided into 9 groups and treated according to protocols.

While no mortality was reported, animals treated with adjuvant HAART and AP recorded least% body weight gain. Significant derangements in serum lipid profiles were exacerbated by treatment of with AP as LDL (increased p < 0.03), triglycerides (increased p < 0.03) with no change in total cholesterol levels. Adjuvant AP with HAART caused reduction in LDL (p < 0.05 and 0.03), increased HDL (p < 0.05) and TG (p < 0.05 and 0.001 for AP₁₀₀ and AP₂₀₀ doses respectively). Markers of liver injury assayed showed significant increase (p < 0.003, 0.001) in AST in AP alone as well as HAART+ vitamins C and E groups respectively. Adjuvant HAART and AP and vitamins C and E also caused significant declines in ALT and ALP levels. Serum GGT was not markedly altered. Disturbances in histopathology ranged from severe hepatocellular distortions, necrosis and massive fibrosis following co-treatment of HAART with vitamins C and E as well as HAART alone. These results warrant caution on the adjuvant use of AP with HAART by PLWHAs as implications for hepatocellular injuries are suspect with untoward cardiometabolic changes.